Antibiotic use in five children's hospitals during 2002–2006: the impact of antibiotic guidelines issued by the Chinese Ministry of Health

2008 ◽  
Vol 17 (3) ◽  
pp. 306-311 ◽  
Author(s):  
Wenshuang Zhang ◽  
Xuzhuang Shen ◽  
Yi Wang ◽  
Yuan Chen ◽  
Min Huang ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Ministry Of Health ◽  
Children's Hospitals ◽  
Children’S Hospitals ◽  
The Impact

Vancomycin Use: Room for Improvement Among Hospitalized Children

2016 ◽  
Vol 30 (3) ◽  
pp. 296-299 ◽  
Author(s):  
Jessica Gillon ◽  
Meng Xu ◽  
James Slaughter ◽  
M. Cecilia Di Pentima
Keyword(s):  
Real Time ◽  
Interrupted Time Series ◽  
Antibiotic Use ◽  
Hospitalized Children ◽  
Interrupted Time Series Analysis ◽  
Prospective Audit ◽  
Children's Hospitals ◽  
Children’S Hospitals ◽  
Before And After ◽  
The Impact

Introduction: The use of vancomycin is common among hospitalized children. We sought to evaluate the impact of prospective audit with real-time feedback on vancomycin use and pharmacy costs. Methods: Vancomycin use was evaluated at Monroe Carell Jr Children’s Hospital at Vanderbilt (MCJCHV) before and after the implementation of prospective audit with intervention and feedback to providers in 2012. Antibiotic use was compared to academic children’s hospitals with established antimicrobial stewardship programs (ASPs). Two similar pediatric academic institutions without an ASP were used as nonintervention controls. Analysis of monthly days of antibiotic therapy (DoT) per 1000 patient-days was performed by interrupted time series analysis. Results: Monthly vancomycin use decreased from 114 DoTs/1000 patient-days to 89 DoTs/1000 patient-days ( P < .0001). We did not find significant differences in the slope of change in vancomycin use between MCJCHV and institutions with ASPs either before or after the intervention ( P = .86 and P = .71, respectively). When compared to children’s hospitals without ASPs, the use of vancomycin was significantly lower at MCJCHV ( P < .001). Conclusion: The use of vancomycin at academic children’s hospitals with an ASP is declining. In our experience, prospective audit with real-time intervention and feedback to providers significantly reduced the use and costs associated with vancomycin.

Quantifying Empiric Antibiotic Use in US Children’s Hospitals

2021 ◽  
Author(s):  
Kathleen Chiotos ◽  
Lauren D’Arinzo ◽  
Eimear Kitt ◽  
Rachael Ross ◽  
Jeffrey S. Gerber
Keyword(s):  
Broad Spectrum ◽  
Antibiotic Use ◽  
Level Variation ◽  
Hospital Level ◽  
Broad Spectrum Antibiotic ◽  
Children's Hospitals ◽  
Broad Spectrum Antibiotics ◽  
Children’S Hospitals ◽  
Days Of Therapy ◽  
Rule Out

OBJECTIVES Empirical broad-spectrum antibiotics are routinely administered for short durations to children with suspected bacteremia while awaiting blood culture results. Our aim for this study was to estimate the proportion of broad-spectrum antibiotic use accounted for by these “rule-outs.” METHODS The Pediatric Health Information System was used to identify children aged 3 months to 20 years hospitalized between July 2016 and June 2017 who received broad-spectrum antibiotics for suspected bacteremia. Using an electronic definition for a rule-out, we estimated the proportion of all broad-spectrum antibiotic days of therapy accounted for by this indication. Clinical and demographic characteristics, as well as antibiotic choice, are reported descriptively. RESULTS A total of 67 032 episodes of suspected bacteremia across 42 hospitals were identified. From these, 34 909 (52%) patients were classified as having received an antibiotic treatment course, and 32 123 patients (48%) underwent an antibiotic rule-out without a subsequent treatment course. Antibiotics prescribed for rule-outs accounted for 12% of all broad-spectrum antibiotic days of therapy. Third-generation cephalosporins and vancomycin were the most commonly prescribed antibiotics, and substantial hospital-level variation in vancomycin use was identified (range: 16%–58% of suspected bacteremia episodes). CONCLUSIONS Broad-spectrum intravenous antibiotic use for rule-out infections appears common across children’s hospitals, with substantial hospital-level variation in the use of vancomycin in particular. Antibiotic stewardship programs focused on intervening on antibiotics prescribed for longer durations may consider this novel opportunity to further standardize antibiotic regimens and reduce antibiotic exposure.

scholarly journals Antibiotic Use for Children with Pneumonia: Sustained Adoption of National Guidelines at United States Children's Hospitals

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Derek J. Williams ◽  
Matthew Hall ◽  
Jeffrey S. Gerber ◽  
Mark Neuman ◽  
Adam L. Hersh ◽  
...  
Keyword(s):  
United States ◽  
Antibiotic Use ◽  
National Guidelines ◽  
Children's Hospitals ◽  
Children’S Hospitals

scholarly journals Analysis of the Design Process of Green Children's Hospitals: Focus on Process Modeling and Lessons Learned

2009 ◽  
Vol 4 (1) ◽  
pp. 121-134 ◽  
Author(s):  
M.M Bilec ◽  
R.J Ries ◽  
K.L Needy ◽  
M Gokhan ◽  
A.F Phelps ◽  
...  
Keyword(s):  
Design Process ◽  
Medical Center ◽  
Children's Hospitals ◽  
Healthcare Facilities ◽  
Children's Hospital ◽  
Children’S Hospitals ◽  
Complex Design ◽  
Children’S Hospital ◽  
Design Requirements ◽  
The Impact

Healthcare facilities are among the most complicated facilities to plan, design, construct and operate. A new breed of hospitals is considering the impact of the built environment on healthcare worker productivity and patient recovery in their design, construction, and operation. A crucial subset of healthcare facilities are children's hospitals where the consequences of poor building system design and performance have the potential to seriously impact young lives with compromised health. Green facilities are not always pursued: they are perceived as difficult to build and costing more than equivalent conventional hospitals. This study explored the design process of the Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center (UPMC) and Penn State's Hershey Medical Center Children's Hospital to understand the critical steps and processes for green children's hospital design. Producing a series of process maps that identify the key characteristics in the complex design requirements of a green children's hospital, this paper reveals the importance of design process to design quality. More broadly, this research will help future project teams meet the complex design requirements of green children's hospitals.

Outpatient antibiotic use and assessment of antibiotic guidelines in Chinese children’s hospitals

2008 ◽  
Vol 64 (8) ◽  
pp. 821-828 ◽  
Author(s):  
Wenshuang Zhang ◽  
Xuzhuang Shen ◽  
Yi Wang ◽  
Yuan Chen ◽  
Min Huang ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Children's Hospitals ◽  
Children’S Hospitals

scholarly journals 1126. Variability in Antibiotic Use in Children’s Hospitals in the United States

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S400-S401
Author(s):  
Hannah Griffith ◽  
Keerti Dantuluri ◽  
Cary Thurm ◽  
Derek Williams ◽  
Ritu Banerjee ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Antibiotic Use ◽  
Surgical Patients ◽  
Hospitalized Children ◽  
Medical Patients ◽  
Broad Spectrum Antibiotic ◽  
Children's Hospitals ◽  
Children’S Hospitals ◽  
Median Hospital ◽  
Research Grant

Abstract Background Understanding patterns of inpatient antibiotic use is necessary to enhance appropriate use and minimize preventable harm at hospitals. Few studies have characterized antibiotic use in the inpatient setting in children. Methods We conducted a cross-sectional study in children admitted to 51 freestanding US children’s hospitals included in the Pediatric Health Information System (PHIS). Overall and broad-spectrum antibiotic use (see Table) were measured using charge data, and prevalence of use was assessed on a single day of each 2017–2018 season over one year. Comparisons were made based on clinical setting (medical vs. surgical), clinical unit (PICU, NICU, and all others), hospital, and region. We assessed the relationship between antibiotic use and median hospital case-mix index (CMI), a surrogate for clinical complexity. Results Of 52769 hospitalized children assessed on a study day, 19174 (36%) received antibiotics, and 6575 (12%) received broad-spectrum antibiotics (table). Overall antibiotic use prevalence varied across hospitals from 22% to 52% (Figure 1). Median hospital CMI had no significant relationship with overall antibiotic use and only a weak correlation (ρ=0.29) with broad-spectrum antibiotic use (Figure 2). Antibiotic use prevalence varied minimally by season, ranging from 36% in fall to 37% in summer. Antibiotic use prevalence was 29% (9470/32436) among medical patients and 48% (9704/20333) among surgical patients. The antibiotics most commonly administered in medical patients were ceftriaxone and ampicillin, while surgical patients most commonly received cefazolin and vancomycin. Regional prevalence ranged from 33% (Midwest) to 40% (West). By unit, PICU patients had the highest prevalence of overall [58% (4006/6874)] and broad-spectrum [27% (1830/6874)] antibiotic use. Children with complex chronic conditions accounted for 63% of hospitalized children but represented 72% of children receiving any antibiotic and 85% of those receiving broad-spectrum antibiotics. Conclusion We observed large and apparently unexplained variability in antibiotic use prevalence among children’s hospitals, clinical settings, and regions. This indicates potential opportunities for enhanced antibiotic stewardship activities. Disclosures Ritu Banerjee, MD, PhD, Accelerate Diagnostics: Grant/Research Support; BioFire: Research Grant; Biomerieux: Research Grant; Roche: Research Grant

Antibiotic use in pulmonology wards of Chinese children’s hospitals: 2002-2006

2009 ◽  
Vol 34 (1) ◽  
pp. 61-65 ◽  
Author(s):  
W. Zhang ◽  
X. Liu ◽  
Y. Wang ◽  
Y. Chen ◽  
M. Huang ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Children's Hospitals ◽  
Children’S Hospitals

scholarly journals Variability in Antibiotic Use at Children's Hospitals

PEDIATRICS ◽  
2010 ◽  
Vol 126 (6) ◽  
pp. 1067-1073 ◽  
Author(s):  
J. S. Gerber ◽  
J. G. Newland ◽  
S. E. Coffin ◽  
M. Hall ◽  
C. Thurm ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Children's Hospitals ◽  
Children’S Hospitals
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